Accounts Receivable Insurance Specialist – Hospital Billing, Medicaid, Denials, Dual Systems Experience

Carle Health

. Manage accounts receivable in accordance with compliance, regulatory, billing, and payer guidelines .

Posted 9/18/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $17 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing accounts receivable, including billing, compliance, and resolving claims issues. Proficient in utilizing clinical applications and payer websites to ensure accurate and timely submission of insurance claims.

Highest-signal resume keywords

Hospital Billing ExperienceMedicaid KnowledgeClaims Resolution SkillsPayer Plan RequirementsHIPAA Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Insurance Claims SubmissionCharge Review EditsClaim EditsClearinghouse RejectionsAccount AdjustmentsCredit/Balance EvaluationRefund ProcessingPayer RecoupmentsDocumentation of Collection ActivitiesResearch and Resolution of Claims

Soft Skills

Problem-Solving SkillsCritical ThinkingInitiativeSensitivity and Discretion

Tools & Technologies

Billing SystemsClinical ApplicationsPayer WebsitesClearinghouses

Industry Keywords

ComplianceRegulatory GuidelinesPayer GuidelinesHealth Insurance ProcessesDenials Management

About the role

Key responsibilities & impact

Manage accounts receivable in accordance with compliance, regulatory, billing, and payer guidelines
Collect outstanding receivables through payer portals and phone lines
Validate coverage and accurately bill insurance claims
Resolve charge review edits, claim edits, clearinghouse rejections, and payer rejections
Follow up on outstanding receivables and complete basic appeals
Answer, document, and complete inquiries from insurance companies, internal departments, and third-party payers
Submit timely claims and non-complex reconsiderations or appeals for community, government, and commercial health plans
Monitor, research, and resolve unpaid, rejected, denied, and allowance-discrepancy claims
Document collection activities in the billing system
Retrieve medical documentation, eligibility information, billing guidelines, referrals, and authorizations using clinical applications and payer websites
Apply undistributed payments to open balances
Review and resolve incoming correspondence
Identify, prepare, and request account adjustments
Resolve insurance setup errors to facilitate timely billing
Evaluate credit/balance accounts and initiate refunds or payer recoupments
Prepare adjusted and corrected bills, accounts-receivable adjustments, and payer appeals
Answer or direct departmental calls through a rotation line
Perform other duties as assigned
Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are processed and paid correctly

Requirements

What you’ll need

Must have Hospital Billing, Medicaid, Denials and Dual Systems experience
Ability to take initiative, accept direction, and seek guidance appropriately
Ability to manage confidential information with sensitivity and discretion in a HIPAA-compliant way
Strong problem-solving and critical thinking skills
Ability to submit accurate electronic and paper insurance claims
Ability to submit non-complex reconsiderations and appeals
Ability to monitor, research, and resolve unpaid, rejected, denied, and allowance discrepancy claims
Ability to analyze accounts and determine appropriate account-resolution actions
Knowledge of payer plan requirements, billing guidelines, and health insurance processes
Ability to use clinical applications, payer websites, billing systems, clearinghouses, and other research systems
Ability to resolve insurance setup errors, charge review edits, claim edits, and payer or clearinghouse rejections
Ability to evaluate credit/balance accounts, refunds, payer recoupments, and allowance discrepancies
Ability to document collection activities accurately and thoroughly
Ability to respond to patients, insurance companies, public agencies, internal departments, and third-party payers
Qualifications list no specific certification, education, or work-experience minimum

Benefits

Comp & perks

Comprehensive benefits package
Day shift schedule, Monday-Friday 8am-5pm
No weekend requirements
No holiday requirements
No on-call requirements